摘要
目的观察和对比他克莫司在儿童激素依赖型肾病综合征（SDNS）和激素耐药型肾病综合征（SRNS）治疗中的疗效和安全性。方法选取80例原发性肾病综合征（PNS）患儿作为研究对象,根据疾病类型将其分为SDNS组61例和SRNS组19例。2组患儿均应用他克莫司联合糖皮质激素进行治疗,对2组患儿治疗前和治疗后4、8、12周的血尿生化指标、血脂指标和凝血纤溶指标进行检测和比较;对2组患儿的疗效、临床有效率及不良反应情况进行观察和比较。结果 2组患儿的血尿生化指标、血脂指标、血浆纤维蛋白原和血浆D二聚体水平均于治疗后4~12周较治疗前显著改善（q=2.736~9.048,P〈0.05）,SDNS组患儿的疗效显著优于SRNS组（U=6.234,P〈0.05）,但2组患儿的临床有效率、血尿生化指标、血脂指标、凝血和纤溶指标及不良反应发生率的差异无统计学意义（χ^2=0.004~0.514,F=0.352~0.907,P〉0.05）。结论应用他克莫司联合激素治疗儿童PNS,可显著改善患儿的临床症状和体征。
Objective To observe and compare the therapeutic effect of tacrolimus on the treatment of children with steroid dependent nephrotic syndrome（ SDNS） or steroid resistant nephrotic syndrome（ SRNS）. Methods Eighty children with primary nephrotic syndrome（ PNS） were selected as the research objects and divided into the SDNS group（ n = 61） and the SRNS group（ n = 19）according to the type of the disease. The children in the two groups were treated with tacrolimus and glucocorticoid therapy. The blood and urine biochemical indexes,the blood lipid indexes,the blood coagulation and fibrinolysis indexes of the children in the two groups before the treatment and 4th,8th and 12 thweeks after the treatment were detected and compared. Therapeutic effects,the clinical efficacy and the adverse events of the children in the two groups were observed and compared. Results The blood and urine biochemical indexes,the blood lipid indexes,the plasma fibrinogen and the plasma D dimer levels of children in the two groups from 4thto 12 thweek after the treatment improved significantly when compared with those before the treatment（ q = 2. 736 ~ 9. 048,P〈0. 05）. The therapeutic effect of the children in the SDNS group was significantly better than that of the SRNS group（ U = 6. 234,P〈0. 05）,but there were no significant differences in the clinical efficacy,the blood and urine biochemical indexes,the blood lipid indexes,and the incidences of adverse events between the two groups（ χ~2= 0. 004 ~ 0. 514,F = 0. 352 ~ 0. 907,P〈0. 05）. Conclusion Application of tacrolimus combined with glucocorticoid in the treatment of children with PNS can significantly improve the clinical symptoms and signs of the children.
出处
《实用临床医药杂志》
CAS
2016年第7期109-112,120,共5页
Journal of Clinical Medicine in Practice
关键词
儿童
肾病综合征
他克莫司
激素耐药
疗效观察
children
nephrotic syndrome
tacrolimus
steroid resistant
effect observation
